Icd Flashcards
Other names of icd
Chest tube
Chest drain
Thoracic catheter
Tube tracheostomy
Intercostal drain
Intercoastalcatheter
Indications
Pneumothorax
Hemonemothorax
Pleural.effusion
Empyema(pus)
Post operative(tracheostomy,eoasophagal surger, cardiothoracic surgery)
Relative risk
Bleeding risk
Diaphrgmatic hernia
Adherant pleura
Device
*made of clear plastic like pvc or soft silicon
*Made in range of sizes by their external dia
*From 6fr to 40 fr
Adults -20fr to 40fr
Children 6fr to 26fr
*End hole and side holes
*Length marker
*Radiopaque line outlines 1st drainage hole
Technique
★Physical examination
Consent
Clinincalsigns
Radiological signs
★Site of insertion
Location of abnormality
5ics mostly mid axillary
2 ics mid clavicular
Incise skin oarellel to rib below the chain intercoastal space
★Aseptic technique
Avoid wound or site infection
★assemble all equipment
Equipment arranged
Diff sizes small for pneumotharx lagge for effusion
★equipment
★local anesthesia
Cleaning antiseptic solution
★licate postion
5th 6th ics mid axillary line
Safe triangle
★incision
Inserted via open surgical incision thoracostomy or using seldinger technique (quide wire and dilator system)
Scalpel-cut-3/4-1.5inch horizontal along ribs
Muscle dilate
Pleura dilate(forceps)
Index fjnger-palpate
Index finger-guide ic tube inserted with clamp at the end which is connected to underwater seal
Suture incision seal
Remove clamp
Confirm xray
Movement water air bubling
Post procedure
Analgesia
Post xray
Document length of draj inserted
Drain bottle below incision level
Daily check watercolumn movement
No kinks or clots present
Record and observe amount
>100cc/gr notify physician
Infection
Clamp test tube
Clamping
Drainage unit broke or disrupted
Air leak
Tension pneumothorax developed
(Bubling chest tube should never be clamped
Complications
Hemorrhage infection and reexposion. Edema
Liver
Spleen
Diaphragm
Thoracic aorta
Heart
Subcutaneous hematoma
Anxiety
Shortness of breath
Subcutaneous emphysema
